Thyroid tumors may be more susceptible to precisely targeted radiation treatment, suggests study

Anaplastic thyroid cancer is almost uniformly fatal, with an average lifespan of about 5 months after diagnosis. And standard treatment for the condition includes 7 weeks of radiation, often along with chemotherapy.

"We put patients through toxic treatment for seven weeks when most will only live five months. I'm not sure that's how I would want to spend my time," says Sana Karam, MD, PhD, investigator at the University of Colorado Cancer Center and assistant professor in the CU School of Medicine Department of Radiation Oncology.

Now a paper published in the journal Thyroid suggests an alternative. Rather than conventional radiotherapy, the paper suggests that thyroid tumors may be more susceptible to treatment with precisely targeted radiation known as stereotactic body radiation therapy (SBRT), and possibly with fewer side effects.

The study was made possible by one of Karam's patients.

"It was one of those journeys that reminds you why we are so fortunate to be physicians," Karam says. The patient was only 50 years old at the time of diagnosis. "I treated him with six or seven weeks of radiation only to find that the cancer had already progressed elsewhere in his body. He had six kids, five of them adopted, and at the end of his life one of the only things he could enjoy eating was ice cream, and so they all enjoyed it together."

After her patient passed, the family created a fundraiser called Cream Cancer that accepted small donations from ice cream parlors near where they lived. Eventually the family raised $10,000, which they donated to the Karam lab to fund research to improve treatments for future thyroid cancer patients.

"My biggest thing was seeing if we could replace seven weeks of radiation with a shorter regimen, say three sessions of targeted radiation instead of thirty of conventional radiation," Karam says.

Because the laboratory of CU Cancer Center colleague, Bryan Haugen, MD, holds one of the largest existing batteries of thyroid cancer cell lines, Karam and first co-authors Andy Phan and Ayman Oweida, PhD, were able to show that anaplastic thyroid cancer cells are almost universally resistant to conventional radiotherapy.

Karam wondered if targeted radiation might succeed where conventional radiation failed. In collaboration with the lab of CU researchers Rebecca Schweppe, PhD, and Nikita Pozdeyev, MD, Karam tested these two radiation strategies in mouse models of the disease.

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"What we found is that not only is this condensed regimen of targeted radiation equivalent to conventional radiation therapy, but it's actually superior, not only in terms of local control but also distantly," Karam says.

Karam's last point is an important one. A common criticism of targeted radiation is the idea that while it may treat the deposits of cancer at which it is aimed, it may not treat invisible deposits of cancer elsewhere in the body - invisible deposits that might be irradiated as a byproduct of more system-wide, conventional radiation therapy. However, recent work in the Karam lab and elsewhere shows that focused radiation may have a systemic effect.

"It may be that SBRT eradicates the root of the cancer so that it can't continue to send out cells that lead to metastases, or it may be that SBRT wakes up the immune system to the presence of cancer, which helps the immune system combat cancer elsewhere in the body," Karam says.

Whatever the mechanism, mice treated with SBRT had less cancer and lived longer than mice treated with conventional radiation.

The work also found a genetic signature of cancers that resist radiotherapy, namely hyper-activation of the gene CXCR4, which is associated with inflammation and has been shown to aid tumor growth in models of other cancer types.

"Because of our patients who are willing to contribute their tumor tissue to create the cell lines we need for our experiments, and because of our expertise with animal models, Colorado is known to be one of the best places for thyroid cancer research," Karam says.

And because of her patient's motivated family who raised money for research through loose change from ice cream parlors, Karam is able to take another step on the path toward demonstrating more effective, less toxic strategies against anaplastic thyroid cancer.

Comments

I may have come upon something that may have groundbreaking results for health. It is a diet that helped my eyes. For the same reasons it helped my eyes, I think it might help many diseases, including AIDS, cancer, and so on.

For about 11 years now, I have been living more than 90% on fluid milk products, cow milk and cow cream. So every day more than 90% of my diet is some kind of milk or milks--nonfat, lowfat, or whole--plus I sometimes buy containers of half-and-half (half milk and half cream) or pure fluid whipping cream and drink them straight.

For me when I eat solid, mixed food my eyes hurt and vision blurs. But if I follow this diet of more than 90% milk and cream they feel and work better. I don't know all the reasons the diet helps. One I'm quite aware of involves how food nutrients affect the cells. So when a person eats or drinks something, first their system breaks it up, then it extracts the nutrients and the nutrients circulate in the blood and reach the cells and nourish the cells. Based on my experience, I would say that even after solid food has been processed by one's digestive system, the nutrients from the solid food still aren't as broken-up as those from milk and cream, and hence when they reach the cells clog the cells more, causing pain and dysfunction. Milk and cream don't clog as much, and hence less pain and dysfunction. That's one reason why I think the diet might help multiple diseases, including cancer.

I got the diet from the Masai tribe of Kenya. They are famous for living only on products from their cows, milk and beef. They do follow one rule of food mixing: "If a man eats meat and drinks milk on the same day, he is a glutton." Since I don't want to be a glutton, I have to choose every day whether it will be a "milk day" or a "meat day." I like beef but prefer milk, so for me it is always a milk day. I don't know if the diet would work if I had occasional beef days. But I'm happy as I am.

I think milk and cream are quite delicious, so I don't think the diet is a sacrifice. At least not for me. I do urinate 30-40 times a day, but that's not really that much trouble, and a small price to pay for feeling much better.

In this interview, AZoNetwork speaks to Knauer about the use of FPLC for purification of proteins and
how their products enable scientists to get the most of liquid chromatography; conducted by Matthew Rafferty

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